Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F17%3A00066851" target="_blank" >RIV/00159816:_____/17:00066851 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/17:00100262

Výsledek na webu

<a href="http://dx.doi.org/10.1007/s00415-017-8461-8" target="_blank" >http://dx.doi.org/10.1007/s00415-017-8461-8</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00415-017-8461-8" target="_blank" >10.1007/s00415-017-8461-8</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry

Popis výsledku v původním jazyce

As there are scarce data regarding the outcomes of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) within 60 min from symptom onset (&quot;golden hour&quot;), we sought to compare outcomes between AIS patients treated within [GH(+)] and outside [GH(MINUS SIGN )] the &quot;golden hour&quot; by analyzing propensity score matched data from the SITS-EAST registry. Clinical recovery (CR) at 2 and 24 h was defined as a reduction of GREATER-THAN OR EQUAL TO10 points on NIHSS-score or a total NIHSS-score of LESS-THAN OR EQUAL TO3 at 2 and 24 h, respectively. A relative reduction in NIHSS-score of GREATER-THAN OR EQUAL TO40% at 2 h was considered predictive of complete recanalization (CREC). Symptomatic intracranial hemorrhage (sICH) was defined using SITS-MOST criteria. Favorable functional outcome (FFO) was defined as a mRS-score of 0-1 at 3 months. Out of 19,077 IVT-treated AIS patients, 71 GH(+) patients were matched to 6882 GH(MINUS SIGN ) patients, with no differences in baseline characteristics (p &gt; 0.1). GH(+) had higher rates of CR at 2 (31.0 vs. 12.4%; p &lt; 0.001) and 24 h (41 vs. 27%; p = 0.010), CREC at 2 h (39 vs. 21%; p &lt; 0.001) and FFO (46.5 vs. 34.0%; p = 0.028) at 3 months. The rates of sICH and 3-month mortality did not differ (p &gt; 0.2) between the two groups. GH(+) was associated with 2-h CR (OR: 5.34; 95% CI 2.53-11.03) and CREC (OR: 2.38; 95% CI 1.38-4.09), 24-h CR (OR: 1.88; 95% CI 1.08-3.26) and 3-month FFO (OR: 2.02; 95% CI 1.15-3.54) in multivariable logistic regression models adjusting for potential confounders. In conclusion, AIS treated with IVT within the GH seems to have substantially higher odds of early neurological recovery, CREC, 3-month FFO and functional improvement.

Název v anglickém jazyce

Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry

Popis výsledku anglicky

As there are scarce data regarding the outcomes of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) within 60 min from symptom onset (&quot;golden hour&quot;), we sought to compare outcomes between AIS patients treated within [GH(+)] and outside [GH(MINUS SIGN )] the &quot;golden hour&quot; by analyzing propensity score matched data from the SITS-EAST registry. Clinical recovery (CR) at 2 and 24 h was defined as a reduction of GREATER-THAN OR EQUAL TO10 points on NIHSS-score or a total NIHSS-score of LESS-THAN OR EQUAL TO3 at 2 and 24 h, respectively. A relative reduction in NIHSS-score of GREATER-THAN OR EQUAL TO40% at 2 h was considered predictive of complete recanalization (CREC). Symptomatic intracranial hemorrhage (sICH) was defined using SITS-MOST criteria. Favorable functional outcome (FFO) was defined as a mRS-score of 0-1 at 3 months. Out of 19,077 IVT-treated AIS patients, 71 GH(+) patients were matched to 6882 GH(MINUS SIGN ) patients, with no differences in baseline characteristics (p &gt; 0.1). GH(+) had higher rates of CR at 2 (31.0 vs. 12.4%; p &lt; 0.001) and 24 h (41 vs. 27%; p = 0.010), CREC at 2 h (39 vs. 21%; p &lt; 0.001) and FFO (46.5 vs. 34.0%; p = 0.028) at 3 months. The rates of sICH and 3-month mortality did not differ (p &gt; 0.2) between the two groups. GH(+) was associated with 2-h CR (OR: 5.34; 95% CI 2.53-11.03) and CREC (OR: 2.38; 95% CI 1.38-4.09), 24-h CR (OR: 1.88; 95% CI 1.08-3.26) and 3-month FFO (OR: 2.02; 95% CI 1.15-3.54) in multivariable logistic regression models adjusting for potential confounders. In conclusion, AIS treated with IVT within the GH seems to have substantially higher odds of early neurological recovery, CREC, 3-month FFO and functional improvement.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Neurology

ISSN

0340-5354

e-ISSN

—

Svazek periodika

264

Číslo periodika v rámci svazku

5

Stát vydavatele periodika

DE - Spolková republika Německo

Počet stran výsledku

9

Strana od-do

912-920

Kód UT WoS článku

000400617200011

EID výsledku v databázi Scopus

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